Thursday, November 01, 2007

You want fries with that?

Hospitals continue experimenting with ways to improve customer service, usually at the expense of employee morale. I've had my own experience with that. When I worked in a busy ER, the three biggest complaints were 1)wait time to be seen 2)wait time to be treated and 3)wait time to get upstairs to a room. Almost always, the Press-Gaineys had nice things to say about the employees. Then some big, upstairs Wahoo comes down and tries to teach the nurses how to say "Please" and "Thank You" and THAT leads to cranky nurses. Boy, you do not want your nurses cranky. In fact, right now, go to your nearest nurse and give her some chocolate. THANK YOU.

Working with donor families has given me a whole new perspective on meeting people's needs. When you've spent 8 hours trying to find out if it's possible to recover sperm from a brain dead husband, suddenly getting a cup of tea and a box of tissues doesn't seem so hard. (Please don't ask how they get the sperm-you really don't want to know). Granted, that's an extreme example, but I was taught that you do whatever you can for the donor family, if at all possible. They're giving a tremendous gift. In return, if they need information, a parking voucher, a cup of coffee or a shoulder to cry on, you give it.

I returned to the unit carrying this credo in my back pocket, I guess, without really thinking about it. So I was surprised to hear people grumbling about, of all things, guest trays for patients' parents. "They just came in and now they want to eat? Why didn't they eat at home?" My first thought is, "Why do you care?" It's not extra work, because dietary brings up the tray. It's not impinging on my Christmas bonus, because the patient is billed. I think there's just a certain type of person who is suspicious that someone, somewhere, is getting away with something. They're not bad people. My dad is one. Just don't kick the ball into their yard.

I have to say, also, that I like being nice. I don't enjoy being in a bad mood(no comments from family members, please). Sometimes, I am so cranky I can't stand myself. Last week I had a woman tell me about her four year old daughter, " I don't know where her attitude problem comes from. Life has made me bitter, what's her excuse?" I'm pretty sure that mom can't stand herself, either. And I think I know where her daughter's attitude problem comes from, too. Believe me when I tell you I am not a perky person. The last time I checked, sunshine and rainbows didn't come out of any of my orifices. I like being a pessimest because I would rather be pleasantly surprised than always disappointed. Still, I have found, more often than not, that when you are kind to people they respond with kindness.

So what's the solution? Can you train "niceness" into people? I recently attended a customer service seminar. Well, it was really only an hour, so I guess that makes it a lecture. A message that says, "We want customer service to be a priority, but not so much that we'll spend $50,000 for the famous motivational speaker. Instead, view his motivational video and then motivate yourselves." (Friendly hint, don't motivate yourselves too much or you'll go blind). Anyway, the lecture instructed us to introduce ourselves, explain to the patient what was going to happen and about how long it would take and then thank the patient. Wha? I think this falls under the category of either you already do it or you can't be taught it. I mean, do they really think there are people sitting there going, "Tell the patient who I am? I had no idea! Up 'til know I've just been going into the room, reaching under their gown and asking them to cough."

I think a lot of crankiness stems from burnout, personally. I was floated to the nursery a few weeks ago and they had that one nurse who just seems to infect the rest of the unit with her bad attitude. You know just what I'm talking about if you've ever worked with this person. She bitchd about everything and everyone, including the babies, who she considered "bad." How can a newborn be bad? Makes me glad that my husband went to the nursery with the baby instead of staying with me. Anyway, I was charting and I looked out the window and all you could see was the roof. Vents and smokestacks and gravel and pigeons. I said, to no one in particular, "Wow, your view sucks." Nurse Cranky asked me to repeat myself. "Your view, out the window. It sure is awful." "Oh," she said, "I thought you were talking about my personal point of view."

Now, if you recognize yourself in that example, it is time for a massage. And a job change. Because, really, working in the nursery is NOT hard. (I'm probably going to get lots of comments from nursery RN's telling me how challenging it is to feed, diaper and rotate the little hamsters. Bring it, is all I got to say).

Somewhere in all this is a point. I suppose if we all had jobs we loved and got paid what we were worth and were able to leave our personal issues at home, we'd all be much nicer to the patients. Then we can tackle peace in the Middle East and world hunger. So here's my 2 cents: Be good to yourself and be good to the people around you. If you start to view the world through crap-colored glasses, take a break, get some perspective and lighten up. And if your friends at work start getting obnoxious, say something to them. Then, we can go to as many customer service seminars as they want, knowing we're still providing the same great care we always gave. And if the hospital wants to take credit for our "pleases" and "thank yous", let 'em.


Oh, yeah. Change of Shift is up at Nurse Ratched's Place. See ya there.


Robin said...

You say we don't, but now, part of me does kind of want to know. You shouldn't tease like that.

PJ Geraghty said...

Robin: TC is don't want to know. One method involves electricity. More than that you don't want to know. Seriously.

PJ Geraghty said...

My father (he of no medical knowledge beyond what you get from watching ER for 14 years) refers to the syndrome you describe as "oculorectosis." It's when the retina and anal nerves cross, and you end up seeing the world through [feces]-colored glasses.

It's not unique to nursing, but I've known several who seemed to have a PhD in it. And it definitely drags everyone else down, like an anchor.

TC said...

Ahh, I finally get Robin to break his silence with a sperm comment. Figures.

Anonymous said...

I stumbled upon your blog...

As a kidney recipient, I just wanted to say, "Thank you!" for what you do. On Tuesday, I celebrated my seven year anniversary! From your entries, I realized you are not directly related to transplantation anymore -- what a shame! But all kidding aside, I just wanted to say I appreciate all your hardwork and dedication. Keep it up!

Transplants, Facts, Thoughts and Opinions said...

Thank you!

I really enjoy your blog. I'm on the other end of your spectrum .... as an organ recipient, I go through the monthly hospital tests and get to see my "Transplant Coordinators" and some of my many Dr's .....

From my perspective, I need to treat these people with kindness & respect. I can see how much it helps them get through their intense days. Plus, they simply deserve it.

Hats off to you, for what you do.